title: Course of illness in a sample of 265 patients with first-episode psychosis--five-year follow-up of the Danish OPUS trial.
abstract: There is an ongoing debate as to whether psychosis is a progressively deteriorating illness or one of progressive amelioration. This paper aims at investigating the rate of recovery and institutionalization and predicting a continuous illness course in a descriptive prospective study of a sub-sample of the OPUS trial of 265 first-episode psychotic patients after five years. Recovery, defined as no psychotic or negative symptoms, living independently, GAF (f)>59, working or studying, was reached for 18% after five years, whereas 13% were institutionalized either at hospital or supported housing after five years. Male gender (OR 1.9, 95% CI 1.06 to 3.23), premorbid social functioning (OR 1.2, 95% CI 1.01 to 1.33), psychotic symptoms (OR 1.3, 95% CI 1.07 to 1.66), and negative symptoms (OR 1.3, 95% CI 1.01 to 1.67) were found to predict a continuous illness course at five-year follow-up. Rates of recovery and institutionalization contradict the assumption that the illness deteriorates progressively, since no changes in the rates are seen from two to five years.
authors.affiliation: Bispebjerg Hospital, Department of Psychiatry, and Copenhagen University Faculty of Health Science, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. mbe_76@yahoo.dk
authors.forename: Mette
authors.initials: M
authors.lastname: Bertelsen
authors.forename: Pia
authors.initials: P
authors.lastname: Jeppesen
authors.forename: Lone
authors.initials: L
authors.lastname: Petersen
authors.forename: Anne
authors.initials: A
authors.lastname: Thorup
authors.forename: Johan
authors.initials: J
authors.lastname: Øhlenschlaeger
authors.forename: Phuong
authors.initials: P
authors.lastname: Le Quach
authors.forename: Torben
authors.initials: T
authors.lastname: Østergaard Christensen
authors.forename: Gertrud
authors.initials: G
authors.lastname: Krarup
authors.forename: Per
authors.initials: P
authors.lastname: Jørgensen
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
mesh_terms: D000328:Adult; D019090:Case Management; D003131:Combined Modality Therapy; D003156:Community Mental Health Services; D015897:Comorbidity; D003718:Denmark; D005196:Family Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D012559:Schizophrenia / Q000453:epidemiology / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012951:Socialization; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D055815:Young Adult